Document Detail


Introducing national guidelines on perioperative chemotherapy for gastric cancer in Norway: a retrospective audit.
MedLine Citation:
PMID:  20627647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 2006, perioperative chemotherapy with epirubicin, cisplatin/oxaliplatin, and capecitabine was recommended in the National Guidelines for patients with resectable gastric cancer in Norway. We conducted a national audit related to clinical aspects, local organisation and the implementation of this multimodal treatment. PATIENTS AND METHODS: All Norwegian departments of oncology were asked to submit aggregated data on gastric cancer patients who had started perioperative chemotherapy for cure; departments of surgery were asked to report on patients undergoing resection after preoperative chemotherapy. Data were retrospectively collected. RESULTS: All 20 departments of oncology and 20 of 21 departments of surgery responded. Of 336 patients operated on for gastric cancer and reported by surgeons, 144 (43%) received preoperative chemotherapy. 169 patients were reported by departments of oncology. 152 (90%) completed the preoperative cycles; 92 (54%) started the postoperative cycles; and 68 (40%) completed all cycles. Toxicity grade >or= 3, overall and haematological, increased during postoperative compared to preoperative cycles, 50 vs. 34% (P = 0.012) and 35 vs. 20% (P = 0.012), respectively. Surgical morbidity and mortality were 26 and <2%, respectively. R0 resection was achieved in 86% of surgically treated patients. Five per cent had a complete pathological response (ypT0) and 48% were node negative (ypN0). Within the first year, the National Guidelines were implemented in 19 of 25 hospitals (76%). CONCLUSIONS: In this population-based series, the tolerability of perioperative chemotherapy reported in the MAGIC trial was reproduced. Toxicity grade >or= 3 was considerable and significantly increased related to postoperative cycles. The National Guidelines were rapidly adopted.
Authors:
T Hølmebakk; G Frykholm; A Viste;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  36     ISSN:  1532-2157     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  610-6     Citation Subset:  IM    
Affiliation:
Department of Surgical Gastroenterology, Oslo University Hospital, Aker, 0514 Oslo, Norway. toto.holmebakk@oslo-universitetssykehus.no
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / drug therapy,  surgery
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use*
Carcinoma / drug therapy*,  pathology,  surgery*
Chemotherapy, Adjuvant
Female
Humans
Male
Medical Audit
Middle Aged
Neoadjuvant Therapy / methods
Norway
Practice Guidelines as Topic
Retrospective Studies
Stomach Neoplasms / drug therapy*,  pathology,  surgery*

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